The prevalence of drug resistance among treatment-naïve HIV-1-infected individuals in China during pre- and post- 2004.

Hanping Li,Lin Li,Wenfu Zhang,Taisheng Li,Shuai Chang,Yongjian Liu,Hongbin Song,Siyang Liu,Daomin Zhuang,Yang Han,Zuoyi Bao,Jingyun Li

doi:10.1186/s12879-016-1928-x

Abstract

BackgroundThe widespread use of antiretroviral therapies has led to considerable concerns about the prevalence of drug-resistant, as transmission of drug-resistant (TDR) strains poses a challenge for the control of the HIV-1 epidemic.MethodsWe conducted an epidemiological study enrolling treatment-naïve HIV-1-positive subjects at the Peking Union Medical College Hospital since 1991. Drug resistance was determined by submitting the sequences to the Stanford University Network HIV-1 database.ResultsOf 521 participants, 478 samples were amplified and sequenced successfully. HIV Transmitted drug resistance prevalence in China was determined to be 6.7 %. We did not find significant differences in the TDR rate by demographic characteristics. No significant time trend in the prevalence of overall TDR was observed (p > 0.05).ConclusionsWe identified an intermediate prevalence of transmitted drug resistance (TDR), exhibiting a stable time trend. These findings enhance our understanding of HIV-1 drug resistance prevalence and time trend, and provide some guidelines for the comprehensive public health strategy of TDR prevention.

Highlights

The widespread use of antiretroviral therapies has led to considerable concerns about the prevalence of drug-resistant, as transmission of drug-resistant (TDR) strains poses a challenge for the control of the Human immunodeficiency virus (HIV)-1 epidemic
Patient characteristics The Peking Union Medical College Hospital provided subjects from a widespread referral network within each of 8 provinces and metropolitan cities across China (Beijing, Shanghai, Guangzhou, Shenzhen, Fuzhou, Henan, Yunnan, and Xi’an) who were treatment-naïve at the time of sampling
A total of 521 subjects infected with HIV-1 during the period 1991–2009 were evaluated; and 491 (94.2 %) of the subjects were from 2005 to 2009

Summary

Introduction

The widespread use of antiretroviral therapies has led to considerable concerns about the prevalence of drug-resistant, as transmission of drug-resistant (TDR) strains poses a challenge for the control of the HIV-1 epidemic. The “Four Frees and One Care” policy implemented in China in 2003, which provided free antiretroviral (ARV) drugs, has been credited for significantly reducing the rate of morbidity and mortality attributed to HIV infection in the country [1, 2]. By August 31st 2013, HIV-1 patients living in 31 provinces and 2215 counties had received antiretroviral therapy (ART) and greatly benefited from this program. Characterized by a high replication rate [3] and the error-prone reverse transcriptase [4, 5], HIV-1 is.

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